Body composition changes after laparoscopic adjustable gastric banding: what is the role of −174G > C interleukin-6 promoter gene polymorphism in the therapeutic strategy?

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Abstract

Background:

There is growing evidence that interleukin-6 (IL-6) is linked to the regulation of fat mass (FM). Our previous data define the common −174G> C IL-6 polymorphism as a marker for ‘vulnerable’ individuals at risk of age- and obesity-related diseases. An association between −174G>C IL-6 polymorphism and weight loss after bariatric surgery has been demonstrated.

Objective:

We investigated the impact of −174G>C IL-6 polymorphism on weight loss, body composition, fluid distribution and cardiometabolic changes in obese subjects, after laparoscopic adjustable gastric banding (LAGB) surgery.

Design and Outcome measures:

A total of 40 obese subjects were studied at baseline and at 6 months follow-up after LAGB surgery. Cardiometabolic and genetic assessment of −174G>C IL-6 polymorphism, anthropometric, body composition and fluid distribution analysis were performed.

Results:

After LAGB surgery, significant reductions in weight (Δ%=−11.66±7.78, P<0.001), body mass index (P<0.001), total and trunk FM (kg, %) (Δ% of total FM=−22.22±12.15, P<0.01), bone mineral density (T-score) (P<0.001), resting metabolic rate (RMR) (P<0.01), and total body water and intracellular water (TBW, ICW) (P<0.05) were observed. At baseline, C(−) carriers of IL-6 polymorphism had a significantly higher RMR (P<0.05), free FM (kg), but less total and trunk FM (%), higher body cell mass (BCM), content of TBW (L) and ECW (extracellular water)/ICW ratio compared with C(+) carriers (P<0.001). After LAGB, C(+) carriers had a significantly stronger reduction of total FM (kg), but lower bone density, compared with C(−) carriers (P<0.05).

Conclusions:

Beyond the relationship between −174G> C IL-6 polymorphism and body composition, this study provides first evidence about the association of IL-6 variant with fluid distribution, at baseline, and FM and bone density loss in obese subjects at 6 months follow-up after LAGB surgery. LAGB was less effective if the subjects were carrying risk genotypes, C(−) carriers, for obesity, suggesting a role of genetic variations on bariatric surgery outcomes.

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